Hale Goksever Celik, MD

Dr. Goksever Celik is an obstetrician and gynecologist, graduated from the medical school of the Hacettepe University in Ankara, and trained through Obstetrics and Gynecology fellowship at Dokuz Eylul University in Izmir. She has been a postdoctoral research fellow at Molecular Biology and Genetics at Istanbul University. She has been participating in several research especially interested in the association between endometriosis surgery and ovarian reserve and the genetic basis of endometriosis.

The comparison of the effect of hemostatic techniques on ovarian reserve during endometrioma cystectomy

The possible negative effect of the surgical excision of endometriomas on the ovarian reserve has brought up the meticulous implementation of the decision for surgical approach. Dr. Raquel Silveria da Cunha Araujo et al, from Brazil, published a study titled as “Ovarian function following use of various hemostatic techniques during treatment for unilateral endometrioma: A randomized controlled trial” in the "International Journal of Gynecology and Obstetrics". The authors sought to evaluate the effect of different hemostatic techniques, namely bipolar energy, hemostatic…

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Persistence of Chronic Pelvic Pain after Hysterectomy

Chronic pelvic pain is defined as the "pain in the pelvic area that lasts for 6 months or longer". There are several gynecological, urological, and gastrointestinal reasons for the development of chronic pelvic pain. Nociceptive pain or central sensitization is the type of pain mechanically different from nociceptive pain which is caused by inflammation or tissue damage, or neuropathic pain that results from nerve damage. The causes are not fully understood but it is thought to be a dysfunction of…

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Impact of surgery before IVF in infertile women with endometrioma

Among the women with endometriosis, 30 to 50% are estimated to have infertility. On the contrary, among women who present with infertility, 25 to 50% are estimated to also have endometriosis. Several mechanisms have been proposed to explain the association between endometriosis and infertility, including anatomic distortion, diminished tubal peristalsis, diminished sperm movements, dysfunctional folliculogenesis, luteal phase dysfunction, alterations in endometrial receptivity. Although the most common treatment modalities for infertility in endometriosis patients are surgical removal of endometriomas and/or IVF…

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Body Mass Index and indicators of metabolic syndrome in women with Endometriosis

Endometriosis is a disease of reproductive-aged women and has common pathophysiological mechanisms with other chronic health morbidities due to its estrogen-dependent chronic inflammatory background. The changes in the inflammatory components of adipose tissue may have an impact on the quality of life in women with endometriosis since the key hormone for this disease is estrogen, and estrogen can be produced by adipose tissue. Park and Chung, from Korea, published a study titled “Differences in metabolic syndrome indicators by body mass index…

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The incidence of endometriosis may vary over time according to age, period and cohort

Endometriosis is an estrogen-dependent gynecological disease mostly encountered in reproductive-aged women. Early diagnosis has importance as endometriosis impairs the quality of life of patients and creates a serious social and economic burden. Fortunately, earlier diagnosis and management of endometriosis becomes possible due to societal, economic, and technological developments. To investigate trends in the incidence of diseases and to evaluate the effects of age, period, and cohort on these trends, age–period–cohort analyses are performed. Feng et al, from China, published a…

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Long noncoding RNAs to predict the endometriosis recurrence

Despite extensive research, the exact pathophysiologic mechanism of endometriosis remains unclear; and the absence of non-invasive biomarkers to diagnose endometriosis is still a big problem both for clinicians and patients. The recurrence of endometriosis is another challenge that is difficult to explain. Chen et al., from China, published a proposal for systematic review entitled “The value of long noncoding RNAs for predicting the recurrence of endometriosis”in the journal named "Medicine (Baltimore)". The authors sought to assess the expression of long…

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A scoping review proposal for the diagnostic and treatment delay of endometriosis

Women with endometriosis suffer from pain for a prolonged time due to diagnostic and treatment delay which is the most challenging aspect of endometriosis. Cromeens et al, from the USA, published a review entitled “Timing, delays, and pathways to the diagnosis of endometriosis: a scoping review protocol” in the journal named BMJ Open. The authors sought to develop a review protocol that will be a source for researchers who want to work on the diagnosis process of endometriosis. Methodologically, they wanted…

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Adenomyosis, fertility, and obstetric outcomes

Adenomyosis is the localization of endometrial glandular and stromal cells within the myometrial wall. Although magnetic resonance imaging has a higher ability to discriminate and identify adenomyosis, transvaginal ultrasonography is a cheaper, more accessible, and practical method in daily clinical practice for the diagnosis of adenomyosis. There is an association between adenomyosis and fertility and obstetric problems depending on various mechanisms such as impaired sperm transport-implantation, uterine dysperistalsis, and presence of high levels of free radicals in the uterine milieu, decreased uterine…

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Does exercise have an effect on pain perception in women with endometriosis?

Endometriosis is an inflammatory disease causing pain symptoms such as dysmenorrhea, dyspareunia, chronic pelvic pain, and also infertility. Several medical and surgical treatment options have been developed to improve quality of life of these women. Despite extensive research, the optimal management of endometriosis still remains unclear. Hansen et al., from Denmark, published a systematic review entitled “Impact of exercise on pain perception in women with endometriosis: A systematic review” in the journal named "Acta Obstetricia et Gynecologica Scandinavica". The authors…

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A pictorial overview of abdominal wall endometriosis

Abdominal wall endometriosis is the most frequent location of extrapelvic endometriosis, and defined as the presence of ectopic endometrial tissue between the peritoneum and the skin through the abdominal wall. Although obstetric or gynecologic surgical history is indispensable for the development of abdominal wall endometriosis, it can rarely be encountered in some women as primary, without any previous operations. The incidence of abdominal wall endometriosis is approximately 3.5% in patients having past gynecological surgery and 0.8% in those with a…

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Postoperative ovulation induction in infertile women with minimal to mild endometriosis

Infertility is an important problem that is encountered in 30-50% of women with endometriosis. Several etiopathogenetic mechanisms for the development of reproductive problems in women with endometriosis have been proposed including abnormal peritoneal microenvironment, ovarian dysfunction and/or decreased oocyte quality, impaired fertilization, and implantation. No consensus has yet been developed for the management of endometriosis-associated infertility. Ovulation induction may be recommended to patients with minimal to mild endometriosis following operative laparoscopy. Zhou et al, from China, published a randomized clinical…

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The higher the cyst fluid iron concentration, the more severe the pain symptom for endometrioma

Endometriosis usually is encountered in three different forms: superficial peritoneal endometriosis, ovarian cysts (endometrioma) and deep infiltrating endometriosis. Endometrioma can be identified as cystic lesions consisting of dark brown endometrial fluid and are sometimes referred to as "chocolate cysts." The presence of endometriomas indicates a more severe stage of endometriosis. Dr. Kobayashi group from Nara Medical University, Japan, recently published a study entitled “Relationship between Cyst Fluid Concentrations of Iron and Severity of Dysmenorrhea in Patients with Ovarian Endometrioma” in the…

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How to predict the complications after laparoscopic bowel resection in women with endometriosis

The endometriotic lesions infiltrating the bowel wall more than 5 mm. are called "deep infiltrating endometriosis". The patients having bowel involvement may have constipation, diarrhea, tenesmus, or rectal bleeding. Surgical management is the main treatment modality to provide benefits on pain, infertility, and digestive symptoms. There is still uncertainty about markers to be used for early diagnosis of complications that may be encountered during the postoperative period. Pécheux et al. from France published a study titled “Predictive value of 4th post-operative-day CRP…

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Progestin suppression for endometriosis before IVF

“Dienogest is a suitable and safe substitute for GnRHa pretreatment in endometriosis patients”, according to the Khalifa et al., from Egypt. Endometriosis is one of the leading reasons for infertility due to decreased oocyte/embryo quality, fertilizability, tubal function, and aberrant endometrial receptivity. In vitro fertilization (IVF) overcomes some mechanisms that lead to infertility in endometriosis patients including removal of oocytes from the toxic peritoneal environment, bypassing tubal factor, and improvement of endometrial receptivity. There are several IVF protocols that are preferred…

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Optimal management of infertility in endometriosis patients

Pelvic pain and infertility are the main symptoms of endometriosis patients. Although the pathophysiological mechanism for infertility is not clearly understood, there are several theories explaining decreased fertility potential in women with endometriosis. Ata and Telek, from Koc and Istanbul Universities of Istanbul, Turkey, recently published an opinion article entitled “Assisted reproductive technology for women with endometriosis, a clinically oriented review” in the journal named "Current Opinion in Obstetrics and Gynecology". The authors aimed to investigate the effect of endometriosis on assisted…

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Immune-mediated conditions and endometriosis in adolescents and adults

The most common presenting complaints of endometriosis are mainly pelvic pain and infertility, commonly in relation to the menstrual period. Affected women demand therapy for these symptoms. Immunologic diseases such as autoimmune and/or inflammatory diseases, allergies, asthma, previous mononucleosis infection, and chronic fatigue and/or fibromyalgia could be encountered in endometriosis patients due to underlying common etiopathogenetic mechanisms.  Shafrir et al, from the Brigham and Women’s Hospital and Boston Children’s Hospital, USA, published a prospective study titled “Co-occurrence of immune-mediated conditions…

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Postoperative treatment and pregnancy points to decreased recurrence risk for ovarian endometriosis

Endometriosis is a disease most frequently diagnosed in women of reproductive age and negatively affects the quality of life. The most common localization for endometriosis is ovaries with a prevalence of 17-44%. Laparoscopic ovarian cystectomy performed as excision or ablation has been accepted as the gold standard approach in these patients. Excision of all visible endometriotic lesions, and adhesiolysis are recommended to restore ovarian anatomy. However, postoperative recurrence can be encountered in women who underwent laparoscopic ovarian cystectomy despite excision of…

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Controlled use of bipolar cauterization as an alternative to endometrioma cystectomy

The main symptoms of endometriosis are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Ablation or coagulation of the cyst wall following laparoscopic drainage of endometrioma may be an alternative treatment for patients with pregnancy intention. Carbon dioxide, laser, and plasma energy and bipolar instruments could be used to achieve ablation. Endometrioma cystectomy may have a negative effect on ovarian function and may reduce the in vitro fertilization success. Chen et al., from the Assisted Reproduction Unitof Sir Run Run Shaw Hospital, School…

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“Advanced gynecological ultrasound” for women with suspected endometriosis

Different clinical forms of endometriosis such as superficial endometriosis, endometrioma, and deep infiltrating endometriosis are present. Although no specific diagnostic tool is available for endometriosis, clinical findings, physical examination and imaging including transvaginal ultrasound and MRI are helpful to determine the treatment and to counsel these patients. Menakaya et al., from Australia and New Zealand, published a study entitled “Awareness and utilisation of advanced gynaecological ultrasound in the preoperative work-up of women planning surgery for endometriosis: A survey of RANZCOG…

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Managing the physical and emotional effects of endometriosis

Endometriosis is known to affect 5-10% of the general population, but some women are underdiagnosed due to physical and psychological disability. Due to the symptoms including dysmenorrhea, dyspareunia, chronic pelvic pain and infertility, endometriosis has a negative effect on the quality of life. The social life of women with endometriosis is disrupted during their menstrual periods. As a result, the patients with endometriosis may also be stigmatized by their partners due to the experiences about the disease. The supportive approach of…

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